On the Difference Between Abreaction and Feeling (Part 7/15)

This is exactly what happens with mock primal therapy. The correct roots have been evaded while driving the patient into false byways. The result? Abreaction. A false root can mean leading the patient into first line, brainstem level where highly charged imprints await. So what does the doctor see as the first line intrudes? Gagging, shortness of breath, squirming, coughing. And what does he do? He encourages the patient to go into it when he is not nearly ready for such a deep experience. What does he get? Abreaction – temporary release plus a residue of feelings that could not be experienced, which push against defenses to make the patient feel bad. More often such great reactions produce fear in the therapist and he avoids dealing with it at all. It is left hanging and unresolved.

 But beware: there is also danger when the therapist is too passive. Those who do not recognize first line on the rise will keep the feeling down and only let it come up for experience when it is far too late. It is too late due to the lack of experience of the therapist who has no idea how to handle pretty strenuous feelings on the rise. So what happens? Abreaction again: feeling different memories from the ones at hand. Again a groove is formed and instead of deep resolving feelings, there are little by-ways that are not resolving. For this timid and reluctant therapist, Freud’s dictum about the unconscious still holds true: don’t go too deep. Freud decided almost one hundred years ago that digging deep into the unconscious was dangerous for the patient and would disturb his equilibrium irrevocably. We have seen the unconscious at work and it is simply not true.

 We therapists need to abjure being omniscient. We don’t know enough, and I cannot even guess how it happened that we became experts in the human condition. Whenever a therapist tells the patient what to feel we know he is already on the wrong path. We must sense feelings and follow the patient, not lead him. We take him by the hand and follow where he leads, not vice versa. We doctors must avoid the temptation to act smart. We spent years in college learning to be smart, and now we must elude it. How ironic! Yet the history of psychotherapy was intellectual and provided a therapy of the intellect, exactly what we don’t need. We don’t let the patient act “smart;” we allow her to act intelligent, to recognize her feelings and how they drive her and cause her to act out. When she tries to act smart we help her get to the feeling; of how to please momma or father. Finally it is a great relief just to be yourself and not have to act this way or that to get love.

 It seems banal and harmless that a therapist supplies insights for the patient, but it is far from that because the patient is given a guess about his feeling from the professional which may be accurate but most often is not because it does not emanate from the patient’s feelings, but from someone else’s. It is a subtle way of channeling the patient into a groove because the therapist is insecure and wants to make sure that the patient is really feeling. And a facile groove is what most people suffer from in abreaction; they find a release to direct their feeling and it becomes comfortable to stay in it. It becomes embedded until they cannot get out of it and they don’t even know they are in it. The force of the feeling, the actual content, finds its groove, and it takes months of proper therapy to help patients out of it. Abreaction has compounded the neurosis rather than eliminating it. Worse, the person is convinced he is better, and he is not. Much worse, the doctor is convinced that all is right, yet nothing is right. The whole process has become a charade; a delusion of wellness. It feels good for the patient because he can release the pressure of the upcoming feeling and that feels like progress: ergo he is getting better.


 When we try to insert ourselves into the feeling process we get a reflection of ourselves, not the patient. And that reflection relies on a host of theories concocted by doctors to explain that which needs no explanation. The mistakes in theory are as myriad as the unconscious of the doctor. He may see a need for power or of meaning or of sex and on and on. He often sees what is not there and refuses to see what is right there. His vision is limited by his openness. And that depends on how much he has felt and experienced of his own pain. You cannot be more open than your repression. That blocks so much: vision, insight, empathy compassion and understanding. If you live in your head you will never consider plunging to the depths of feeling; it is then all about explaining feelings, discussing them or writing about them. There is a form of therapy today where patients believe they can get well by keeping a journal about their feelings. Again, it is too obvious for comment but it is the top level that is embraced when we need to push far below it. The same is true for mindfulness therapy, which enhances attention and asks the patient to concentrate on details such as rate of breathing. This keeps that top level super-attentive when it should lie quietly. In these therapeutic schemes, there is no way to go deeper when every move that is made in therapy militates against feeling. They cannot go deeper because they are locked into kind of abreaction themselves. There is no larger, encompassing frame of reference that can guide them. They are as diverted from feelings as the patient who abreacts.

 These cognitive theories are based on a basic distrust of feelings in favor of intellect; the opposite of one needs to produce a feeling cure. When a doctor defines his therapy as cognitive, he has already lost. It means he will deal with half the brain to the neglect of the other parts; above all the feeling parts; those parts that are healing.